粪便K—ras12基因突变和血清CA19—9CEA联合检测在胰腺癌早期诊断中的价值  

作　　者：滕卫军[1] 朱以军[1] 陈燕萍[1] 施昕[1] 厉学民[1] 

机构地区：[1]浙江省金华市中心医院,321000

出　　处：《浙江临床医学》2015年第2期184-185,共2页Zhejiang Clinical Medical Journal

摘　　要：目的评价粪便K-ras 12基因突变和血清CA19-9、CEA联合检测在胰腺癌早期诊断中的价值。方法对2006年7月到2010年6月38例胰腺癌患者（早期8例、中晚期30例）和175例胰腺良性疾病患者的粪便K-ras12基因突变和血清CA19-9、CEA的阳性率进行比较和分析。结果胰腺癌组粪便K-ras12基因突变和血清CA19-9、CEA的阳性率显著高于胰腺良性疾病组；早期胰腺癌组粪便K-ras12基因突变阳性率显著高于良性疾病组，而血清CA19-9、CEA的阳性率与良性疾病组比较无显著差异；中晚期胰腺癌组粪便K-ras12基因突变阳性率显著高于早期胰腺癌组．而血清CA19-9、CEA的阳性率与早期胰腺癌组比较无显著差异。粪便K-ras12基因突变、血清CA19-9、CEA诊断早期胰腺癌的敏感性分别为50％、37．5％、37．5％，特异性分别为89．7％、77．1％81．1％。用平行法联合检测粪便K—ras12基因突变和血清CA19-9、CEA诊断早期胰腺癌的敏感性为87．5％、特异性74．2％；用系列法联合检测粪便K-ras基因突变和血清CA19-9、CEA诊断早期胰腺癌的敏感性为25％、特异性为94．9％。结论粪便K-ras12基因突变和血清CA19．9、CEA的联合检测可显著提高诊断早期胰腺癌的敏感性和特异性。Objective Abstract Objective To explore the value of combining the test of gerte mutation of K-ras12 in stool samples and serum CA 199 and CEA for the early diagnosis of pancreatic cancer. Methods The gene mutation of K-ras12 in stool samples and elevated serum level of CA 199 and CEA of 38 cases of pancreatic cancer（8 cases of early stage, 30 cases of middie and late stage） and of 175 cases with pancreatic benign diseases from July, 2006 to June, 2010 were compared and analyzed. Results The gene mutation of K-ras12 in stool samples were significantly higher in the early stage of pancreatic cancer, while the rate of elevated serum level of CA 199 and CEA was not significantly different from the benign group; in the middle and late stage of pancreatic cancer, the gene mutation of K-ras12 in stool samples were significantly higher while the rate of elevated serum level of CA 199 and CEA was not significantly different from the benign group. The sensitivity rates of gene mutation of K-ras12 in stool samples and the elevated serum level of CA 199 and CEA in the diagnosis of early pancreatic cancer were 50 % ~ 37.5%, 37.5%, with the specificity of 89.7 %, 77.1% and 81.1%, respectively. Combined test with paralleled method for the detection of gene mutation of K-ras12 in stool samples and the elevated serum level of CA 199 and CEA has the sensitivity rate of 25% and the specificity rate of 97.6%. Conclusions Combined test with paralleled method for the detection of gene mutation of K-ras12 in stool samples and the elevated serum level of CA 199 and CEA can significantly increase the sensitivity rate and the specificity rate for early pancreatic cancer.

关 键 词：胰腺肿瘤K-ras12基因 肿瘤标志物 

分 类 号：R735.9[医药卫生—肿瘤]